JP2011194126A - Guide tube for endoscope or treatment tool - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a guide tube being simple in construction and small in outside diameter and yet capable of transformation of flexibility in bending directions from a flexible structure to a highly rigid structure in a secure and reliable manner.SOLUTION: In order to secure a path of insertion for an insertion rod 2 of an endoscope 1 and for transformation of flexibility from a flexible structure to a rigid structure in the bending directions, a guide tube is constituted by a flexible double tube 13 having flexible inner and outer tubes 11 and 12 which are flexible in bending directions and fitted one on the other to define a hermetically closed inner space therebetween. Muscle members 14, each composed of a friction strip 15 and attached with a metal wire 16, are provided at predetermined angular positions between the inner and outer tubes. Dislodgements of the muscle members 14 from the respective angular positions are prevented by restraint rings 17. The muscle members 14 are subjected to positional regulation in a rotating direction by restraint rings 17, and a suction tube 18 from a suction pump unit 19 is connected to the flexible double tube.

Description

  INDUSTRIAL APPLICABILITY The present invention is used to stably hold an insertion portion of an endoscope when the insertion portion is inserted into a body cavity to observe or inspect the body or perform a necessary treatment. The present invention relates to a guide tube of an endoscope or a treatment instrument.

  An endoscope is normally inserted along an insertion path such as the upper digestive tract or the lower digestive tract. For example, as shown in Patent Document 1, the endoscope is perforated from the stomach. A procedure for opening a path for bypassing the insertion portion of the endoscope to the transverse colon in the large intestine is performed. For this purpose, since it is necessary to suppress the invasiveness to a minimum, there are cases where it is not always possible to smoothly insert the insertion portion to open a route for performing treatment or the like.

  The insertion part of the endoscope has a soft structure, and even if this insertion part cannot be smoothly inserted through the route established by perforation, or even if it is inserted to the site to be treated, the tip becomes unstable, If it is as it is, an appropriate treatment may not be accurately performed. Further, in the process of inserting the insertion portion along the path existing in the body with the endoscope for the lower digestive tract, for example, to straighten the sigmoid colon so as to pass through the sigmoid colon, etc. In some cases, it is necessary to adjust the insertion path of the insertion portion, such as forcing the path into a straight line.

  From the above, Patent Document 1 proposes using an overtube as a guide tube for guiding an insertion portion of an endoscope. Here, the overtube for guiding the insertion portion of the endoscope must have a flexible structure until the insertion path of the endoscope is established. Of course, since the path of the insertion portion of the endoscope is ensured, the waist is held from this insertion portion. After securing the route to the site to be treated, the endoscope can be easily inserted and further stiffened to ensure the stability of the treatment tool during the treatment. desirable.

  That is, it is desirable that the guide tube used for securing the insertion path of the endoscope can be configured to change the hardness according to the situation. The overtube of Patent Document 1 is not configured to make the hardness variable. A configuration capable of changing the hardness of the guide tube is disclosed in Patent Literature 2 and Patent Literature 3.

  The configuration of the hardness variable pipe of Patent Document 2 is such that a large number of ring members whose both end surfaces are inclined surfaces are sequentially connected, and a plurality of operation wires are inserted through these ring members. is there. In the state where the operation wire is loosened and no pressure contact force is applied between the inclined end surfaces of the front and rear ring members, flexibility is obtained in the bending direction, and tension is applied to the operation wire so that the front and rear ring members are inclined. When press-contacting, the rigidity is increased. Further, the hardness variable tube of Patent Document 3 is composed of inner and outer double tubes, and the outer peripheral surface of the inner tube and the inner peripheral surface of the outer tube have a shape with irregularities directed in the axial direction, and If a sealed space is formed between both tubes and this sealed space is kept at atmospheric pressure, both tubes will be separated, resulting in a flexible structure with high flexibility in the bending direction, and the sealed space in a negative pressure state. If it does, it will contact | adhere in the state which the uneven | corrugated | grooved part of both tubes meshed | engaged, and comes to become highly rigid.

Special table 2008-502421 gazette JP-A-2005-318956 Japanese National Patent Publication No. 5-503434

  In the above-described hardness variable pipe of Patent Document 2, since a large number of ring members are arranged, the number of parts increases. In particular, in order to bend smoothly, it is necessary to shorten the length of each ring member, and the length of the hardness variable tube will be increased according to the length of the insertion path of the endoscope. For this reason, there are problems such as an enormous number of ring members constituting the variable hardness tube.

  On the other hand, in the hardness variable tube of Patent Document 3, since the uneven portion directed in the axial direction is formed, if the sealed space is made negative with the hardness variable tube curved, the uneven portion of the inner tube is formed. And the concavo-convex part of the outer tube may not be accurately engaged with each other, and a predetermined hardness may not be obtained. In addition, since the inner tube and the outer tube each have predetermined irregularities, each flexible tube requires a maximum height and a predetermined space. As a result, the thickness of the variable hardness tube is increased and the diameter is increased. Has the problem of becoming large.

  The present invention has been made in view of the above points. The object of the present invention is to have a simple configuration, a small outer diameter, and a hardness in a flexible state and a highly rigid state in a bending direction. An object of the present invention is to provide a guide tube for an endoscope or a treatment instrument in which changes occur accurately and reliably.

  In order to achieve the above-mentioned object, the present invention provides an inner tube having a distal end, a proximal end, and a longitudinal axis and having flexibility in a bending direction, and is arranged so as to cover the inner tube. An outer tube having flexibility in the bending direction connected directly or indirectly to the distal end side and the proximal end side, and in a sealed space defined between the inner tube and the outer tube, An engagement surface that is arranged in parallel with the longitudinal axis of the inner tube and engages with at least one of the inner tube or the outer tube, and a strength holding member that does not expand and contract in the longitudinal axis direction and has flexibility in the bending direction; A long muscular body having at least one of the inner tube and the outer tube, and restricting the muscular body from moving in the circumferential direction around the longitudinal axis of the inner tube in the sealed space. A regulating portion that has an opening in the sealed space in which the section is formed, and in the sealed space And a fluid supply / discharge unit that presses the engagement surface against at least one of the inner tube and the outer tube by discharging the fluid and releases the pressed state by supplying the fluid into the sealed space. It is characterized by that.

  The inner tube has a distal end, a proximal end, and a longitudinal axis, is flexible in the bending direction, and is inserted through the insertion portion of the endoscope. Regardless of the path to be newly opened, even if the insertion path is bent in a complicated manner, a passage for inserting the insertion section must be secured. For this purpose, the inner tube must have the required shape retention and be flexible in the bending direction. In consideration of the above points, it is desirable that the cross section of the inner tube cut by a plane passing through the axis has a convex shape on the outer surface side and a smooth surface on the inner surface. The convex part may be a ring-like part or a spirally wound part. Of course, in addition to this, for example, a spiral metal wire or the like may be embedded in a soft synthetic resin tube, or a bellows-shaped one may be used.

  The outer tube is flexible in the bending direction, but need not have shape retention. From the viewpoint of reducing the diameter, it is preferable to configure as a thin tube material. The inner surface of the outer tube may be roughened or smoothened. It is desirable that the outer surface of the outer tube be slippery.

  The muscle body is interposed between the inner tube and the outer tube, and is composed of a friction strip having a predetermined width as an engagement surface and a strength holding member, and the strength holding member is integrated with the friction strip. Has been. Here, the engagement surface is the mutual engagement with the muscular body and / or the inner or outer tube, so that the muscular body is not displaced relative to the inner or outer tube. Retained. Here, when one of the inner tube and the outer tube is a member having shape retaining property and the other is a thin member, the member having shape retaining property and the muscular body are engaged so as not to shift relative positions. . The strength holding member can be composed of a linear body (metal wire, carbon fiber, or the like) made of a material with low stretchability embedded in the friction strip. The strength holding member is more preferably a metal wire having a circular cross section in order to prevent directivity with respect to bending. When the muscle body is not in close contact with the inner tube or the outer tube and is in a free state, the muscle body has a certain degree of flexibility in the bending direction. When the muscular body is constrained by being pressed between the inner tube and the outer tube, the strength holding member does not expand or contract mainly, so that it becomes a resistance body against changes in the bending state, and the flexible double tube has high rigidity. Will do. Therefore, if a large number of muscle bodies are provided, the difference in flexibility between the flexible state and the high-rigidity state of the flexible double tube can be increased, and the directionality becomes wider. However, if a large number of muscle bodies are provided in a fixed manner in the circumferential direction, the configuration may be complicated. If the bending direction is constant, only one muscular body may be provided. Usually, by using a plurality of pipes, preferably three or four, the flexible double pipe can be highly rigid in all directions.

  The strength holding member can be formed of a hollow member made of a densely wound coil, for example, a metal wire. An operation wire for push-pull operation with a fixed distal end is inserted into the hollow member, and the hollow member is configured to extend from the base end portion of the operation wire. As a result, by appropriately applying tension to the operation wire, the bending of the flexible double tube is controlled in the state of being inserted into the insertion path, and the configuration can be changed from the bent state to the straightening direction. be able to. Further, the operation wire for controlling the bending of the flexible double tube does not need to be provided integrally with the muscular body. The operation wire is provided independently of the strength holding member of the muscular body, and the tip of the operation wire is provided. It is also possible to fix to the distal end of the flexible double tube, position it in the circumferential direction, move in the axial direction, and push and pull the base end.

  A flexible double tube composed of an inner tube and an outer tube bends along the insertion path, but the muscular body located on the inner side of the bending direction, that is, on the side having a small curvature radius, is relative to the flexible double tube. Since the radius of curvature is increased on the outer side in the bending direction, it is contracted relative to the flexible double tube. Therefore, the muscular body needs to be movable in the front-rear direction. The length of the muscular body is shorter than that of the flexible double tube. The degree of shortening is determined according to the degree of bending of the path through which the guide tube is inserted. In addition, the muscular body must always be positioned on the distal end side of the flexible double tube. Therefore, it is desirable to fix the muscular body at one point to either the inner tube or the outer tube. Therefore, the fixing position is preferably in the vicinity of the tip, and may be any position from the tip to the middle portion.

  The muscular body must be fixedly held in the circumferential direction of the flexible double tube. For this purpose, a regulating part is provided. The restricting portion is fixed to the inner tube or the outer tube and has a muscular body insertion portion, and can be configured to sew a thread for locking the muscular body. In this restricting ring, a concave insertion portion is provided at the arrangement position of each muscle body. A plurality of regulating rings are provided with a predetermined pitch interval, and this pitch interval is an interval necessary for ensuring the stability of the muscle body. In addition, when the wall thickness of the inner tube or the outer tube, particularly the inner tube, is increased, a groove wider than the width of the muscle body can be formed on the outer surface of the inner tube to function as a restricting portion. . Although the muscular body protrudes from the outer surface of the inner tube, when the muscular body is accommodated in the groove, the protruding amount of the muscular body from the outer surface of the inner tube can be reduced. However, it is necessary to make the depth of the groove shallower than the thickness of the muscle body. In order to hold the muscular body so as not to deviate from the groove, the above-described regulating ring can be used, and when the outer tube surrounding the muscular body exhibits a muscular body deviation preventing function, the regulating ring is used. Need not be provided.

  The annular space between the inner tube and the outer tube is closed by closing both ends of the flexible double tube, and fluid supply / discharge means is connected to this, but the supplied / discharged fluid is gas Alternatively, it can be a liquid, and is preferably a gas such as air.

  An endoscope with a small outer diameter dimension by minimizing the difference in diameter between the inner tube and the outer tube with a simple structure in which a muscular body is incorporated into a flexible double tube comprising an inner tube and an outer tube. Alternatively, the guide tube of the treatment instrument is formed, and the change in hardness between the flexible state and the highly rigid state can be accurately and reliably generated in the bending direction.

It is an external view which shows the guide tube in the state which penetrated the endoscope. It is a perspective view which shows the principal part of a guide tube. It is XX sectional drawing of FIG. It is YY sectional drawing of FIG. It is an external view of a muscular body. It is a front view of a control ring. It is operation | movement explanatory drawing which shows the change from a flexible state to a highly rigid state of a guide tube. It is composition explanatory drawing of the muscular body which shows the 2nd Embodiment of this invention. It is a principal part perspective view of the guide tube which shows the 3rd Embodiment of this invention. It is an external appearance perspective view of the inner tube | pipe which shows the 4th Embodiment of this invention.

    Hereinafter, embodiments of the present invention will be described with reference to the drawings. First, FIG. 1 shows the appearance of a guide tube incorporating an endoscope. In FIG. 1, reference numeral 1 denotes an endoscope. The endoscope 1 has a configuration in which an insertion portion 2 for insertion into a body cavity is connected to a main body operation portion 3. The insertion portion 2 includes a distal end hard portion 2a, a curved portion 2b, and a flexible portion 2c from the distal end side. The soft part 2c is a member that is flexible in the bending direction. The distal rigid portion 2a is provided with an illumination unit that illuminates the inside of the body cavity, and an observation window for acquiring an image inside the body cavity under illumination from the illumination unit. In addition, a treatment instrument outlet for inserting forceps, a high-frequency treatment instrument and the like is opened. In addition, since the structure of the endoscope 1 is conventionally well-known, detailed illustration and description are abbreviate | omitted.

  2 and 3, reference numeral 10 denotes a guide tube. The guide tube 10 has a distal end, a proximal end, and a longitudinal axis, and covers an inner tube 11 having flexibility in a bending direction, and the inner tube. And a flexible double tube 13 comprising an outer tube 12 having flexibility in the bending direction and connected directly or indirectly to the distal end side and the proximal end side of the inner tube 11. A muscle body 14 is provided between the inner tube 11 and the outer tube 12, and the muscle body 14 is provided at four locations in the circumferential direction in the present embodiment. As shown in FIG. 4, the inner tube 11 is made of a soft resin and has a structure in which ring-shaped members having a substantially semicircular cross section are sequentially connected. That is, the inner pipe 11 is formed such that an outer surface of the inner pipe 11 is provided with a ring-shaped protrusion having a semi-cylindrical shape facing the circumferential direction, and a first pipe portion having a first outer diameter, The second pipe line portion having an outer diameter larger than the outer diameter of the tube portion has uneven portions arranged alternately along the longitudinal axis, and the inner surface is formed from a cylindrical smooth surface. It is configured. By configuring the inner tube 11 in this way, it is a highly stretchable member that has high flexibility in the bending direction, does not substantially expand or contract, or at least has low stretchability, and has high crush resistance. It will be a thing.

  Since the outer tube 12 is made of a non-stretchable thin tube material, and the outer tube 12 is directly exposed in the body cavity, it requires characteristics such as good slipping and high chemical resistance. On the other hand, as will be described later, the inner surface of the outer tube 12 has good adhesion to the muscular body 14, and therefore may be roughened. From the viewpoint of safety, a smooth surface may be used.

  As shown in FIG. 5, the muscle body 14 has a friction strip 15 made of an elastic member such as rubber having a substantially rectangular cross section, and a metal constituting a strength holding member is provided inside the friction strip 15. A wire 16 is embedded. The friction strip 15 is assembled at four equal intervals in the circumferential direction so that one side surface 15A faces the outer surface of the inner tube 11 and the other side surface 15B faces the inner surface of the outer tube 12. The muscle body 14 is fixed to the outer surface of the inner tube 11 at any position from the distal end portion or near the distal end to the intermediate portion, and extends toward the proximal end side in the axial direction of the flexible double tube 13. It is attached to let you. Further, the length of the muscle body 14 is shorter than that of the flexible double tube 13. By providing a difference in length between the flexible double tube 13 and the muscular body 14 in this way, when the guide tube 10 is bent along the insertion path, the radius of curvature of the bending angle on the inner peripheral side, The muscular body 14 protrudes toward the base end side by the difference in the radius of curvature at the center line, but the difference in length generated at this time can be absorbed. Therefore, the degree of difference varies depending on the degree of bending of the path through which the guide tube 10 is inserted.

  In the present embodiment, four muscle bodies 14 are provided, and each muscle body 14 is arranged so as to have a phase of 90 degrees, but is held so as not to move in the circumferential direction. I am doing so. For this purpose, the flexible double pipe 13 is provided with restriction rings 17 constituting a plurality of restriction portions with a predetermined pitch interval in the axial direction, and is fixed to the outer surface of the inner pipe 11. The restriction ring 17 is preferably lightweight and made of a plastic made of a hard member, and as shown in FIG. 6, there are insertion portions 17a through which the muscle bodies 14 are inserted at four positions every 90 degrees as shown in FIG. Is formed. The width dimension of the insertion part 17a is slightly larger than the width dimension of the streaks 14, and the depth dimension is slightly deeper than the thickness dimension of the streaks 14. As a result, the movement of the muscle body 14 is restricted by the restriction ring 17 in the circumferential direction, but the movement is not restricted in the axial direction.

  The inner tube 11 and the outer tube 12 constituting the guide tube 10 are fixed at the front and rear ends thereof. Therefore, a space between the inner tube 11 and the outer tube 12 is a sealed space. A muscular body 14 and a regulating ring 17 are arranged in the space. As shown in FIG. 1, the suction pipe 18 is connected to the sealed space, and the other end of the suction pipe 18 is connected to the suction pump unit 19.

  The guide tube 10 is configured as described above. In the body cavity tube, the guide tube 10 is inserted along a predetermined insertion path, or the body cavity inner wall is perforated to open the insertion path. In any case, the guide tube 10 is not inserted alone, but is inserted so as to incorporate the endoscope 1. This is to confirm the insertion path in the body. Therefore, the distal end hard portion 2 a of the insertion portion 2 of the endoscope 1 inserted through the guide tube 10 faces the distal end of the guide tube 10 or a portion up to the bending portion 2 b is protruded from the guide tube 10. An illumination window and an observation window are formed on the distal end surface of the distal end rigid portion 2a, so that a visual field in the front in the insertion direction can be obtained.

  The flexible portion 2c in the insertion portion 2 of the endoscope 1 is bent in an arbitrary direction, and the guide tube 10 is also provided with a muscular body 14 on a flexible double tube 13 of the inner tube 11 and the outer tube 12. Therefore, the muscle body 14 is configured to be bendable. Therefore, the guide tube 10 and the endoscope 1 inserted through the guide tube 10 can be smoothly inserted along the insertion path.

  When the insertion portion 2 of the endoscope 1 inserted through the guide tube 10 is fixed for observation or treatment at a predetermined position, the suction pump 19 is operated to connect the inner tube 11 from the suction pipe 18. And suction from the sealed space between the outer tube 12 and the outer tube 12. As a result, as shown in FIG. 7, the outer tube 12 in the guide tube 10 is in close contact with the inner tube 11. At this time, the outer tube 12 is pressed against the other surface 15B of the friction strip 15 of the muscle body 14 provided at four locations. As a result, the one side surface 15 </ b> A of the friction strip 15 is in close contact with the outer surface of the inner tube 11. That is, one side surface 15A of the friction strip 15 is an engagement surface. Here, since the friction strip 15 is made of an elastic member such as rubber and the inner tube 11 is also made of a soft member, the one side surface 15A constituting the engagement surface of the friction strip 15 is the inner tube 11. The muscle body 14 is restrained by being pressed against the outer surface. As a result, the muscular body 14 is frictionally engaged between the inner tube 11 and the outer tube 12 and is fixedly held at that position.

  Since the muscle body 14 includes the metal wire 16 as a strength holding member, when the muscle body 14 is pressed against the inner tube 11, the flexibility of the inner tube 11 in the bending direction is lowered. . As a result, the entire guide tube 10 becomes highly rigid, and the insertion portion 2 of the endoscope 1 inserted through the guide tube 10 is secured in the bending direction.

  As a result, for example, when a treatment tool such as a forceps or a high-frequency treatment tool is led out from a treatment tool outlet port opened in the distal end hard part 2a of the insertion portion 2 of the endoscope 1, the distal end hard part 2a Becomes stable, and an accurate treatment can be performed. In addition, when applying force to the mucous membrane or the like with the treatment tool, the endoscope itself has been moved by the reaction force and it has been difficult to apply force. It is possible to reduce the movement and apply force.

  For example, when the insertion portion 2 of the endoscope 1 is further advanced along the newly established path after performing a treatment for perforating the stomach wall, the suction by the suction pump unit 19 is released, and the guide tube 10 By allowing the air to flow into the guide tube 10, the guide tube 10 is restored to a state of being flexible in the bending direction again, so that it can travel along the path.

  By the way, in embodiment mentioned above, the guide tube 10 will be highly rigid in the state bent along the path | route, and a curve cannot be controlled. In order to increase the rigidity after correcting the bent guide tube 10 to be almost straight, the muscle body 114 shown in FIG. 8 is used. As is clear from the figure, the muscle body 114 is the same as that of the first embodiment described above in that it has the friction strip 115, but the strength holding member is not made of a metal wire, but is dense. The hollow strength holding member 116 is formed in a wound coil shape. The operation wire 120 is inserted into the hollow strength holding member 116, and the distal end of the operation wire 120 is fixed to the distal end portion of the hollow strength holding member 116 as a fixing portion 121 by means such as adhesion or brazing. To do. On the other hand, the base end portion of the operation wire 120 is configured to be led out from the base end portion of the hollow strength holding member 116 and lead out to the outside from a sealed portion between the inner tube 11 and the outer tube 12.

  If comprised as mentioned above, the muscle body 114 will exhibit the function similar to the muscle body 14 mentioned above by making the operation wire 120 into a free state. In order to increase the rigidity of the guide tube 10, when straightening the bending of the insertion path, the operation wire 120 inserted through the hollow strength holding member 116 of the muscle body 114 located on the outer peripheral side of the bending is provided. Operate to pull. As a result, the bent guide tube 10 can be straightened, and the insertion path can be straightened. If comprised in this way, operation etc. which linearize a sigmoid colon etc. can be performed in a colonoscope, for example.

  Further, when the strength holding member is formed of the metal wire 16, for example, as shown in FIG. 9, the operation wire 220 may be provided at a position between the muscles 15 and 15 in the circumferential direction. In order to position these operation wires 220 in the circumferential direction, insertion thread 221 is provided at a predetermined location on the outer peripheral surface of the inner tube 11 so that the operation wire 220 can be pushed and pulled. The guide tube 10 as a whole can be made highly rigid after the bending of the insertion path is straightened. Of course, also in this case, the distal end of the operation wire 220 is fixed to the distal end of the inner tube 11 or in the vicinity of the distal end, and the proximal end portion of the operation wire 20 is exposed to the outside from the sealed portion between the inner tube 11 and the outer tube 12. Let it be derived.

  Furthermore, if configured like the inner tube 111 shown in FIG. 10, the muscle body 14 (the same applies to the muscle body 114 in the second embodiment) instead of the restriction ring 17 shown in the first embodiment. Can be made to function as a means for positioning in the circumferential direction. As described above, the inner tube 11 has a concavo-convex portion in which the outer surface forms a ring-shaped ridge shaped like a kamaboko shape in the circumferential direction, but the inner tube 111 is formed by cutting the protruding portion. The groove 130 is oriented in the axial direction of the longitudinal axis. Here, the width dimension of the groove 130 is slightly larger than the width dimension of the streak body 14. Further, the depth of the groove 130 is made smaller than the thickness dimension of the muscle body 14.

  If comprised as mentioned above, the muscular body 14 can be accommodated in the groove | channel 130 of the inner tube | pipe 111, and it can prevent that it shifts | deviates to a circumferential position. Moreover, the protrusion height to the outer surface can be reduced by the amount of the muscle 14 inserted into the groove 130, and the outer diameter of the guide tube can be reduced as a whole. However, if the muscle body 14 is configured to be completely embedded in the groove 130, the outer tube presses the other surface 14B of the muscle body 14 and presses against the inner tube 111 when the sealed space is sucked. Therefore, the muscular body 14 must protrude from the most protruding portion of the inner tube 111 in the groove 130.

  In this case, if the outer body 12 can regulate the muscle body 14 so as not to deviate from the groove 130, the muscle body 14 only needs to be accommodated in the groove 130, but the muscle body 14 may deviate from the groove 130. In such a case, a restriction ring similar to that shown in FIG. 6 is provided at an appropriate location.

DESCRIPTION OF SYMBOLS 1 Endoscope 2 Insertion part 10 Guide tube 11,111 Inner tube 12 Outer tube 13 Flexible double tube 14,114 Muscle body 15,115 Friction strip 16 Metal wire 17 Restriction ring 18 Suction piping 19 Suction pump unit 120, 220 Operation wire 130 Groove

Claims (11)

An inner tube having a distal end, a proximal end, and a longitudinal axis and having flexibility in a bending direction;
An outer tube that is arranged so as to cover the inner tube, and is flexible in the bending direction and connected directly or indirectly to the distal end side and the proximal end side of the inner tube;
An engagement surface that is disposed in parallel with the longitudinal axis of the inner tube in a sealed space defined between the inner tube and the outer tube and engages with at least one of the inner tube and the outer tube; A long muscular body having a strength holding member that does not expand and contract in the longitudinal axis direction and has flexibility in the bending direction;
A restricting portion that is provided on at least one of the inner tube or the outer tube and restricts the muscle body from moving in the circumferential direction around the longitudinal axis of the inner tube in the sealed space;
There is an opening in the partitioned sealed space, and the fluid is discharged from the sealed space to press the engagement surface against at least one of the inner tube and the outer tube, and the fluid enters the sealed space. Fluid supply / discharge means for releasing the pressed state by supplying
A guide tube for an endoscope or treatment instrument. In the inner pipe, first pipe portions having a first outer diameter and second pipe portions having an outer diameter larger than the first outer diameter are alternately arranged along the longitudinal axis. The endoscope or treatment instrument guide tube according to claim 1. 3. The endoscope or treatment instrument guide tube according to claim 1, wherein the outer tube is made of a non-stretchable tube material. The endoscope or treatment according to any one of claims 1 to 3, wherein four muscle bodies are arranged with a phase of 90 degrees with respect to the longitudinal axis of the inner tube. Tool guide tube. The endoscope or treatment instrument guide tube according to any one of claims 1 to 4, wherein the engagement surface is made of an elastic member. The endoscope or treatment instrument according to any one of claims 1 to 5, wherein the strength holding member is configured by a metal wire having a circular cross section and embedded in the muscle body. Guide tube. The endoscope according to any one of claims 1 to 6, wherein the muscle body is shorter than the length of the inner tube and the outer tube, and at least one end is a free end. Or a guide tube for a treatment instrument. The inner tube or the outer tube has an operation wire having a distal end fixed to a distal end side of the inner tube or the outer tube and an other end extending to a proximal end side of the inner tube. The guide tube of the endoscope or treatment instrument according to any one of claims 1 to 5. The restricting portion is composed of an annular member, and is composed of a restricting ring in which the insertion portion of the muscle body is formed at a predetermined position in the circumferential direction. The restricting ring is spaced at a predetermined pitch in the axial direction of the inner tube. The endoscope or treatment instrument guide tube according to any one of claims 1 to 8, wherein the guide tube is configured to be fixed at a plurality of locations. The restricting portion is composed of a positioning groove provided on the outer surface of the inner tube, and the positioning groove has a groove width larger than the width of the muscle body and a groove depth smaller than the thickness of the muscle body. The guide tube for an endoscope or treatment instrument according to any one of claims 1 to 9. The endoscope or treatment instrument guide tube according to any one of claims 1 to 10, wherein the fluid supply / discharge means supplies and discharges gas.

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